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becky: THER EX > LECTURE 4: MODALITIES > Flashcards

LECTURE 4: MODALITIES Flashcards

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1
Q

ultrasound indications

A

Acute and post-acute conditions (non-thermal effects)
● Calcium deposits
● Chronic inflammation
● Delayed soft tissue healing
● Dermal ulcers
● Joint contractures
● Muscle spasm
● Myofascial trigger points
● Pain
● Plantar warts
● Scar tissue
● Tissue regeneration

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2
Q

ultrasound contra indications

A

● Areas of active bleeding
● Areas of decreased temperature
sensation
● Areas of decreased circulation
● Deep vein thrombosis
● Infection
● Malignancy
● Over breast implants
● Over carotid sinus or cervical ganglia
● Over epiphyseal areas in young
children
● Over eyes, heart, and genitalia
Over methylmethacrylate cement area (TKR) or plastic
● Over pelvic, lumbar or abdominal areas in pregnant women
● Over pacemaker
● Thrombophlebitis
● Vascular insufficiency

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3
Q

ultrasound is a what?

A

Sound frequency (acoustic energy in waves) that is deep heat modality!!!! up to 5 cm

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4
Q

true or false: ultrasound can be thermal and nonthermal

A

true!

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5
Q

What is attenuation?

A

decrease in energy intensity bc some of ultrasound waves got bent due to reflection or refraction

This is why we use gel and sound head firmly against body part

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6
Q

US passes through _____ content, and is absorbed in ___tissues

A

passes through high water content, absorbed in high protein like tendon
frequency increases, absorbtion increases

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7
Q

small area, what sound head size?

A

smaller the transducer size, more contact with the skin

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8
Q

Treatment area should be what compared to effective radiating area

A

2-3x effective radiating area

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9
Q

Larger transducer and higher frequency = more

A

collimation (focus of the beam)

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10
Q

a higher BNR means

A

losing lot of energy/heat inside the unit

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11
Q

What are 4 parameters of ULTRASOUND

A

duty cycle (pulsed vs continuous)-miliseconds!!!! 5th of a sec
frequency
intensity
treatment time

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12
Q

ERA IS

A

The portion that produces the sound wave
○ Energy output is greatest at the center
○ Is is smaller than the transducer size
○ Treatment area = 2-3x ERA

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13
Q

What does

A

thermal: CONTINUOUS DUTY CYCLE
non-thermal: pulsed! 1 ms on/4 ms off duty cycle is 20%, 1/5th

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14
Q

nonthermal effects are what?

A

good for early inflammatory phase
cavitation and microstreaming!
good for 1st 2 weeks of tissue healing and for stable fractures!

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15
Q

does thermal effects have tissue healing properties?

A

not really, mainly warms up tissues!

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16
Q

ultrasound frequency is WHAT

A

depth!!!! 0.75-3 MHz

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17
Q

1 MHz frequency ultrasound settings:

A

DEEP TISSUES! goes up to 5 cm
-if cushioned
-if quads, hams, thicker areas

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18
Q

3 MHz ultrasound frequency

A

3 MHz: shallower depth (1-3 cm) for superficial tissues

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19
Q

nonthermal duty cycle is for

A

acute injury, edema, tissue healing (no temp increase!)

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20
Q
A
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21
Q
A
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22
Q

what do you do for documentation?

Study These Flashcards
A

Body part to be treated
○ Modality used
○ Patient position
○ Treatment duration
○ Parameters
○ Patient response to treatment
○ Skin effects
○ Outcome measure

*communicate to other providers so they can let them do the same

23
Q

WHAT IS HIGH VOLT PULSED CURRENT

Study These Flashcards
A

does same numbers as russian!
paired monophasic wave
modulation: none
muscle contraction
CAN BE GOOD FOR WOUNDS, EDEMA**

24
Q

iontophoresis is WHAT

Study These Flashcards
A

continuous direct current to deliver medicine! Drives ions into body…. through skin/mucous membranes

25
iontophoresis cathode has a
alkaline effect
26
iontophoresis anode has a
acidic effect (+)
27
iontophoresis dosage of med
40 mA-min dose = 4 mA x 10 min 40 mA-min=2 mA x 20 min amount of med is same, but what changes is INTENSITY and TIME
28
dexamethasone
polarity: negative 4 mg/mL tendonitis!!! bursitis!!!!
29
lidocaine
polarity: pos 4% lidocain for: trigeminal neuralgia
30
acetate
2-5% acetic acid for CALCIUM DEPOSITS (-)
31
iontophoresis indications
Analgesia ● Calcium deposits (bone spurs) ● Dermal ulcers ● Edema reduction ● Fungal infections ● Hyperhidrosis ● Muscle spasms ● Musculoskeletal inflammatory conditions- tendonitis
32
ionto contras
Those general rules for EStim ● Impaired skin sensation ● Allergy or sensitivity to medication ● Denuded area of recent scars ● Cuts, bruises, or broken skin ● Metal in or near treatment area
33
how can ionto burns happen?
Chemical: usually alkaline reaction at cathode ● Heat: high resistance to flow, poor contact ● Irritation/rash: allergy to medication
34
how can you minimize burns?
Decrease current density ● Inspect skin prior to application ● Ensure sufficient filling of medication ● Ensure good contact with skin ● Ask about allergy to medications
35
what is biofeedback?
Used to measure motor unit action potentials (MUAP) . ● Signals are detected, amplified, and converted to audiovisual signals ● Electronic or mechanical instrument used to help patient develop greater voluntary control via relaxation or neuromuscular re-education NO SHOCKING
36
Biofeedback is for
muscle re-education! beeps loader with more contraction
37
EMG biofeedback is used in conjunction with patient’s ______to increase or decrease muscle activity towards a functional goal.
voluntary contractions/efforts!
38
what does biofeedback measure?
skin temp skin conductance vasoconstriction or pulse via phototransm EMG activity pressure
39
who do you use biofeedback on?
● Good vision, hearing, and communication abilities ● Good comprehension of simple commands and concentration ● Good motor planning skills ● No profound sensory or proprioceptive loss
40
how does heat transmission occur?
Conduction ● Convection ● Radiation ● Conversion
41
conduction works by
CONDUCTION OVEN DIRECT CONTACT cooling penetrates deeper than heat! does not go deep, less than 1 cm deep
42
Convection
body in contact with moving fluid (air or liquid) ● Hot or cold whirlpool ● Fluidotherapy ● Whole or partial body cryotherapy
43
radiation
Transfer of energy (not necessarily heat) to the body without physical contact. -Laser ● UV light ● Infrared lamps
44
conversion
Energy changes from one type (i.e. sound, electromagnetic energy) into another (i.e. heat)
45
ultrasound is what? CONVERSION
US: Sound waves create vibration of molecules which produces heat
46
diathermy is what? CONVERSION
Dia: EM energy induces electrical fields and heat currents within the tissue.
47
factors affecting thermal transfer
Temperature difference between modality and tissue Treatment time Exposure of body area to modality Specific heat and mass of body and source Type of heat transfer * Conduction > Convection > Conversion > Radiation
48
thermotherapy indications
Modulate pain ● Increase connective tissue extensibility ● Reduce or eliminate soft tissue inflammation and swelling ● Accelerate rate of tissue healing ● Reduce or eliminate soft tissue or joint restriction ● Reduce muscle spasm
49
thermotherapy contras
Acute and early subacute traumatic and inflammatory conditions ● Decreased circulation ● Decreased sensation ● DVT ● Impaired cognitive function ● Malignant tumors ● Tendency toward hemorrhage or edema ● Very young patients ● Elderly
50
thermotherapy precautions
Cardiac insufficiency ● Edema ● Impaired circulation ● Impaired thermoregulation ● Metal in treatment area ● Pregnancy ● Topical counterirritants recently applied ● Demyelinated nerves ● Open wounds
51
what increases with heat?
CO metabolic rate pulse rate RR vasodilation
52
what decreases?
BP mm activity Blood flow to internal organs and blood flow to resting muscle stroke volume
53
aquatic therapy is good for what arthritic condition?
RA
54

becky: THER EX (11 decks)

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